Organization Active NPI

Compass Medical Clinic

  • Primary Care Clinic/Center
  • San Jose, CA
National Provider Identifier
1457935884
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMPASS MEDICAL CLINIC
Practice address
1340 Tully Rd Ste 309
San Jose, CA 95122-3055
Phone
(408) 993-8536
Fax
(408) 993-8539
NPI assigned
May 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gina N Bui, MDNPI 1962736926
Title
Physician
Phone
(408) 993-8536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1340 Tully Rd Ste 309
San Jose, CA 95122-3055

Mailing address

1340 Tully Rd Ste 309
San Jose, CA 95122-3055
Phone (408) 993-8536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211109002807 CA Part B Supplier - Clinic/Group Practice 9830588045 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2270051Compass Medical Clinic1340 Tully Rd, San Jose, CA 95122Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1457935884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 TULLY RD STE 309",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951223055",
            "telephone_number": "408-993-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 TULLY RD STE 309",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951223055",
            "telephone_number": "408-993-8536",
            "fax_number": "408-993-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "408-993-8536",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.